Provider Demographics
NPI:1740343003
Name:WANG, AIFEI (LAC MAC)
Entity type:Individual
Prefix:
First Name:AIFEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC MAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16220 FREDERICK RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877
Mailing Address - Country:US
Mailing Address - Phone:301-963-5200
Mailing Address - Fax:301-963-5125
Practice Address - Street 1:16220 FREDERICK RD
Practice Address - Street 2:SUITE 404
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877
Practice Address - Country:US
Practice Address - Phone:301-963-5200
Practice Address - Fax:301-963-5125
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDU01266171100000X
VA0121000333171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist